A Practice Facilitation and Academic Detailing Intervention Can Improve Cancer Screening Rates in Primary Care Safety Net Clinics.

Background: Despite the current evidence of preventive screening effectiveness, rates of breast, cervical, and colorectal cancer in the United States fall below national targets. We evaluated the efficacy and feasibility of combining practice facilitation and academic detailing quality improvement (QI) strategies to help primary care practices increase breast, cervical, and colorectal cancer screening among patients.

Methods: Practices received a 1-hour academic detailing session addressing current cancer screening guidelines and best practices, followed by 6 months of practice facilitation to implement evidence-based interventions aimed at increasing patient screening.

Instrumental activity of daily living limitations and supports in a clinic population of low-income Puerto Rican elderly adults with chronic diseases.

Latino older adults in the United States have disproportionately high rates of chronic and disabling medical conditions. Puerto Ricans have a higher prevalence of several chronic medical conditions and higher rates of functional disability than other Latinos. Earlier studies have documented that Puerto Rican older adults traditionally have relied mostly on family members for assistance with their functional needs, with low use of formal support services, but little is known about their functional help needs and caregiving practices.

Pharmacologic therapy for acute pain.

The approach to patients with acute pain begins by identifying the underlying cause and a disease-specific treatment. The first-line pharmacologic agent for the symptomatic treatment of mild to moderate pain is acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID). The choice between these two medications depends on the type of pain and patient risk factors for NSAID-related adverse effects (e.

Reimbursement and practice policies among providers of buprenorphine-naloxone treatment.

Unlabelled: ABSTRACT Background: Physician acceptance of cash payment and low adherence to practice guidelines may contribute to buprenorphine-naloxone diversion. The purpose of this study was to investigate the clinical practice policies of physicians who provide office-based treatment for opioid dependence with buprenorphine-naloxone.

Methods: Data were obtained from 31 of 71 practices surveyed (response rate 43.

What happens to orders written for older primary care patients?

Background And Objectives: Data are limited on order completion errors in primary care. The objective of this study was to determine the incidence and nature of order completion errors among community-dwelling older adults.

Methods: This prospective, cross-sectional exploratory study was conducted at a suburban family medicine clinical teaching site.

Knowledge and use of ethnomedical treatments for asthma among Puerto Ricans in an urban community.

Purpose: Puerto Ricans have higher lifetime and current asthma prevalence than other racial and ethnic groups in the United States. A great many Hispanics use ethnomedical therapies for asthma. This study elicited participant knowledge of ethnomedical therapies, developed a typology of the therapies, and considered whether some types are used or deemed efficacious based, in part, on information source.

Improving quality of NSAID prescribing by internal medicine trainees with an educational intervention.

Background: Prescribing nonsteroidal anti-inflammatory drugs (NSAIDs) for older adults is a safety concern. Education innovations in postgraduate training designed to improve patient safety should comply with the Accreditation Council for Graduate Medical Education (ACGME).

Purpose: The objective is to evaluate a seven-component education program for internal medicine trainees designed to change prescribing practices while addressing ACGME competencies.

The epidemiologic association between opioid prescribing, non-medical use, and emergency department visits.

Introduction: Since the 1990s prescriptions for and the non-medical use of opioids have increased. This study examines associations between opioid prescribing, non-medical use, and emergency department (ED) visits.

Methods: Data were abstracted from four federally sponsored, nationally representative, annual surveys (National Hospital Ambulatory Medical Care Survey, National Ambulatory Medical Care Survey, National Survey on Drug Use and Health, and Drug Abuse Warning Network).

Assessment of safety attitudes in a skilled nursing facility.

Safety has not been well studied in the long-term care setting. This pilot study assesses staff attitudes regarding safety culture at one 250-bed skilled nursing facility. A valid and reliable Safety Attitudes Questionnaire (SAQ) was administered once to a sample of 51 employees.